TOLOSA CHILDRENS DENTAL CENTER: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization: TOLOSA CHILDRENS DENTAL CENTER (EIN 77-0346861)
Tax period: 2021-07-01 to 2022-06-30
Filed: 2022-11-14
IRS object ID: 202233189349310073
Schema version: 2021v4.2
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule D
Schedule G
Schedule J
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2022-11-14T13:10:55-06:00	ReturnTs
Tax Period End	2022-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	262350873	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	CALIBER AUDIT & ATTEST LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	805 AEROVISTA PLACE SUITE 103	AddressLine1Txt
City	SAN LUIS OBISPO	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	93401	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2021-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	770346861	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	TOLOSA CHILDREN'S DENTAL CENTER	BusinessNameLine1Txt
Business Name Line2	OF SAN LUIS OBISPO COUNTY	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
Business Name Control	TOLO	BusinessNameControlTxt
Phone	8052385334	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	717 WALNUT DRIVE	AddressLine1Txt
City	PASO ROBLES	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	93446	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JON HOLLISTER	PersonNm
Person Title	PRESIDENT	PersonTitleTxt
Phone	8052385334	PhoneNum
Signature	2022-11-14	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	JON	PersonFirstNm
Person Last	HOLLISTER	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	KIMBERLYN SPILLER CPA	PreparerPersonNm
PTIN	P01491937	PTIN
Phone	8058880242	PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	3	TrustedCustomerCd
Authentication Assurance Level	AAL1	AuthenticationAssuranceLevelCd
Identity Assurance Level	IAL1	IdentityAssuranceLevelCd

Field	Value	IRS element (for citing)
Tax	2021	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	JON HOLLISTER	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	717 WALNUT DRIVE	AddressLine1Txt
City	PASO ROBLES	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	93446	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$1,706,213	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	TOLOSACHILDRENSDENTAL.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1993	FormationYr
Legal Domicile State	CA	LegalDomicileStateCd
Activity Or Mission	TO PROVIDE DENTAL SERVICES FOR UNDERPRIVILEGED CHILDREN IN SAN LUIS OBISPO COUNTY	ActivityOrMissionDesc
Voting Members Governing Body	10	VotingMembersGoverningBodyCnt
Voting Members Independent	10	VotingMembersIndependentCnt
Total Employee	21	TotalEmployeeCnt
Total Volunteers	10	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$645,347	PYContributionsGrantsAmt
CY Contributions Grants	$251,626	CYContributionsGrantsAmt
PY Program Service Revenue	$1,094,831	PYProgramServiceRevenueAmt
CY Program Service Revenue	$1,390,566	CYProgramServiceRevenueAmt
PY Investment Income	$3,577	PYInvestmentIncomeAmt
CY Investment Income	-$13,013	CYInvestmentIncomeAmt
PY Other Revenue	-$14,376	PYOtherRevenueAmt
CY Other Revenue	-$25,209	CYOtherRevenueAmt
PY Total Revenue	$1,729,379	PYTotalRevenueAmt
CY Total Revenue	$1,603,970	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$1,033,217	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$1,077,621	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$100,215	CYTotalFundraisingExpenseAmt
PY Other Expenses	$361,166	PYOtherExpensesAmt
CY Other Expenses	$365,096	CYOtherExpensesAmt
PY Total Expenses	$1,394,383	PYTotalExpensesAmt
CY Total Expenses	$1,442,717	CYTotalExpensesAmt
PY Revenues Less Expenses	$334,996	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$161,253	CYRevenuesLessExpensesAmt
Total Assets BOY	$2,584,715	TotalAssetsBOYAmt
Total Assets EOY	$2,725,551	TotalAssetsEOYAmt
Total Liabilities BOY	$91,997	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$71,580	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$2,492,718	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$2,653,971	NetAssetsOrFundBalancesEOYAmt
Mission	TO PROVIDE DENTAL SERVICES FOR UNDERPRIVILEGED CHILDREN IN SAN LUIS OBISPO COUNTY.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$1,184,743	ExpenseAmt
Revenue	$1,390,566	RevenueAmt
Desc	TO PROVIDE DENTAL SERVICES TO UNDERPRIVILEDGED CHILDREN IN SAN LUIS OBISPO COUNTY. PRODUCTION PROGRAM REVENUE IS DERIVED MAINLY FROM DENTI-CAL REIMBURSEMENTS AND IS REPORTED NET OF CLAIMS ADJUSTMENTS.	Desc
Total Program Service Expenses	$1,184,743	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	0	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	0	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	0	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	0	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	Yes (1)	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	0	OperateHospitalInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	0	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	18	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	21	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	Yes (1)	QuidProQuoContributionsInd
Quid Pro Quo Contri Discl	Yes (1)	QuidProQuoContriDisclInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	10	GoverningBodyVotingMembersCnt
Independent Voting Member	10	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	0	MembersOrStockholdersInd
Election Of Board Members	0	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	0	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	CA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	SUZANNE RUSSELL	PersonNm
Phone	8052382216	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	717 WALNUT DRIVE	AddressLine1Txt
City	PASO ROBLES	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	93446	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
JON HOLLISTER DDS
PRESIDENT	5.00	Yes (X)	Yes (X)	$0	$0	$0
JAMES TEDFORD MD
VICE PRESIDENT	1.00	Yes (X)	Yes (X)	$0	$0	$0
SCOTT MILSTEAD
TREASURER/SECRETARY	1.00	Yes (X)	Yes (X)	$0	$0	$0
CHUCK BRAUN
DIRECTOR	0.50	Yes (X)		$0	$0	$0
ROBYN FLORES DMD
DIRECTOR	0.50	Yes (X)		$0	$0	$0
LAURIE TORGERSON
DIRECTOR	0.50	Yes (X)		$0	$0	$0
HEIDI WILLIAMS
DIRECTOR	0.50	Yes (X)		$0	$0	$0
KRISTIN KEARNS
DIRECTOR	0.50	Yes (X)		$0	$0	$0
SHAUNA HAYES DMD
DIRECTOR	0.50	Yes (X)		$0	$0	$0
SUZANNE RUSSELL
EXECUTIVE DIRECTOR	50.00		Yes (X)	$82,108	$0	$8,315
ALEXANDRA CHAMBERLAIN
DIRECTOR OF DEVELOPMENT	40.00		Yes (X)	$63,359	$0	$2,018
DIEU VO DDS
EMPLOYEE-DENTIST	40.00			$132,660	$0	$5,615	Yes (X)
THOMAS NAKATSUCHI DDS
EMPLOYEE-DENTIST - FORMER	40.00			$196,505	$0	$12,515		Yes (X)
RACHEL WILLIAMS
EMPLOYEE-DENTIST - FORMER	40.00			$0	$0	$0		Yes (X)
MARTIN DUNNE DDS
EMPLOYEE-DENTIST - FORMER	32.00			$0	$0	$0		Yes (X)
KIM TRINH
EMPLOYEE-DENTIST - FORMER	40.00			$0	$0	$0		Yes (X)
JU LAWRENCE
EMPLOYEE-DENTIST - FORMER	24.00			$0	$0	$0		Yes (X)
ANDREA N LIVINGOOD DDS
EMPLOYEE-DENTIST - FORMER	40.00			$0	$0	$0		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$474,632	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$28,463	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	2	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	0	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K	0	CntrctRcvdGreaterThan100KCnt
Fundraising	$107,167	FundraisingAmt
Government Grants	$51,226	GovernmentGrantsAmt
All Other Contributions	$93,233	AllOtherContributionsAmt
Noncash Contributions	$10,600	NoncashContributionsAmt
Total Contributions	$251,626	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PRODUCTION PROGRAM REV	621300	$1,070,808	$1,070,808
DTI INCENTIVES	621300	$319,758	$319,758

Field	Value	IRS element (for citing)
Total Program Service Revenue	$1,390,566	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,498	TotalRevenueColumnAmt
Exclusion	$2,498	ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$15,511	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	-$15,511	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$15,511	TotalRevenueColumnAmt
Exclusion	-$15,511	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$61,523	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$107,167	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$86,732	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$25,209	TotalRevenueColumnAmt
Exclusion	-$25,209	ExclusionAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,603,970	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,390,566	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	-$38,222	ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$168,191	TotalAmt
Management And General	$99,378	ManagementAndGeneralAmt
Fundraising	$68,813	FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$775,143	TotalAmt
Program Services	$775,143	ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$14,990	TotalAmt
Program Services	$13,791	ProgramServicesAmt
Management And General	$1,199	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$51,029	TotalAmt
Program Services	$45,645	ProgramServicesAmt
Management And General	$5,384	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$68,268	TotalAmt
Program Services	$58,711	ProgramServicesAmt
Management And General	$5,461	ManagementAndGeneralAmt
Fundraising	$4,096	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$16,101	TotalAmt
Program Services	$313	ProgramServicesAmt
Management And General	$9,357	ManagementAndGeneralAmt
Fundraising	$6,431	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$710	TotalAmt
Management And General	$710	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$12,985	TotalAmt
Management And General	$12,985	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$4,422	TotalAmt
Fundraising	$4,422	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$5,667	TotalAmt
Program Services	$5,461	ProgramServicesAmt
Management And General	$118	ManagementAndGeneralAmt
Fundraising	$88	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$28,617	TotalAmt
Program Services	$21,467	ProgramServicesAmt
Management And General	$7,150	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$38,556	TotalAmt
Program Services	$38,556	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$80,139	TotalAmt
Program Services	$68,920	ProgramServicesAmt
Management And General	$6,411	ManagementAndGeneralAmt
Fundraising	$4,808	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$19,201	TotalAmt
Program Services	$16,513	ProgramServicesAmt
Management And General	$1,536	ManagementAndGeneralAmt
Fundraising	$1,152	FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
DENTAL SUPPLIES	$76,142	$76,142
REPAIRS	$15,096	$15,096
OUTSIDE SERVICE	$8,256	$7,184	$516	$556
DUES	$5,582	$5,582

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$53,622	TotalAmt
Program Services	$36,219	ProgramServicesAmt
Management And General	$7,554	ManagementAndGeneralAmt
Fundraising	$9,849	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,442,717	TotalAmt
Program Services	$1,184,743	ProgramServicesAmt
Management And General	$157,759	ManagementAndGeneralAmt
Fundraising	$100,215	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$1,845,394	BOYAmt
EOY	$1,975,649	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$155,861	BOYAmt
EOY	$156,556	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$75,673	BOYAmt
EOY	$114,230	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$13,948	BOYAmt
EOY	$14,913	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$1,001,358	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$537,155	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$493,839	BOYAmt
EOY	$464,203	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,584,715	BOYAmt
EOY	$2,725,551	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$81,697	BOYAmt
EOY	$71,580	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$10,300	BOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$91,997	BOYAmt
EOY	$71,580	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,492,718	BOYAmt
EOY	$2,653,971	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$2,492,718	BOYAmt
EOY	$2,653,971	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$2,584,715	BOYAmt
EOY	$2,725,551	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$161,253	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	Yes (1)	AccountantCompileOrReviewInd

Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp

Field	Value	IRS element (for citing)
Separate Basis Fincl Stmt	Yes (X)	SeparateBasisFinclStmtInd

Field	Value	IRS element (for citing)
FS Audited	0	FSAuditedInd
Audit Committee	0	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Public Organization170	Yes (X)	PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$182,202	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$305,106	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$252,884	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$229,876	CurrentTaxYearMinus1YearAmt
Current Tax Year	$288,336	CurrentTaxYearAmt
Total	$1,258,404	TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$182,202	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$305,106	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$252,884	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$229,876	CurrentTaxYearMinus1YearAmt
Current Tax Year	$288,336	CurrentTaxYearAmt
Total	$1,258,404	TotalAmt

Field	Value	IRS element (for citing)
Public Support Total170	$1,258,404	PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$1,888	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$5,873	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$5,659	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$3,892	CurrentTaxYearMinus1YearAmt
Current Tax Year	$2,498	CurrentTaxYearAmt
Total	$19,810	TotalAmt

Field	Value	IRS element (for citing)
Total Support	$1,278,214	TotalSupportAmt
Public Support CY170	0.98450	PublicSupportCY170Pct
Public Support PY170	0.98390	PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170	Yes (X)	ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$448,950	InvestmentCostOrOtherBasisAmt
Depreciation	$142,641	DepreciationAmt
Book Value	$306,309	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$552,408	InvestmentCostOrOtherBasisAmt
Depreciation	$394,514	DepreciationAmt
Book Value	$157,894	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$464,203	TotalBookValueLandBuildingsAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART X, LINE 2:	FormAndLineReferenceDesc
Explanation	THE ORGANIZATION'S ACTIVITIES ARE GENERALLY EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND SECTION 23701(D) OF THE CALIFORNIA FRANCHISE TAX CODE. SINCE THE ORGANIZATION IS EXEMPT FROM FEDERAL AND STATE INCOME TAX LIABILITY, NO PROVISION IS MADE FOR CURRENT OR DEFERRED INCOME TAX EXPENSE. THE ORGANIZATION IS NOT A PRIVATE FOUNDATION. MANAGEMENT IS NOT AWARE OF ANY TRANSACTIONS THAT WOULD IMPACT THE ORGANIZATION'S TAX-EXEMPT STATUS. FOR THE YEAR ENDED JUNE 30, 2022, MANAGEMENT OF THE ORGANIZATION IS NOT AWARE OF ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE ACCOUNTED FOR IN THE FINANCIAL STATEMENTS UNDER THE PRINCIPLES OF THE INCOME TAXES TOPIC OF THE FASB (ASC). THE ORGANIZATION RECOGNIZES INTEREST AND PENALTIES, IF ANY, RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE. ALL TAX EXEMPT ENTITIES ARE SUBJECT TO REVIEW AND AUDIT BY FEDERAL, STATE AND OTHER APPLICABLE AGENCIES. SUCH AGENCIES MAY REVIEW THE TAXABILITY OF UNRELATED BUSINESS INCOME, OR THE QUALIFICATION OF THE TAX-EXEMPT ENTITY UNDER THE INTERNAL REVENUE CODE AND APPLICABLE STATE STATUTES.	ExplanationTxt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	ANNUAL APPEAL	Event1Nm
Gross Receipts Event1	$16,425	GrossReceiptsEvent1Amt
Charitable Contri Event1	$16,425	CharitableContriEvent1Amt
Other Direct Expenses Event1	$4,879	OtherDirectExpensesEvent1Amt
Event2	SUNSET BBQ	Event2Nm
Gross Receipts Event2	$141,659	GrossReceiptsEvent2Amt
Charitable Contri Event2	$80,136	CharitableContriEvent2Amt
Gross Revenue Event2	$61,523	GrossRevenueEvent2Amt
Non Cash Prizes Event2	$36,711	NonCashPrizesEvent2Amt
Rent Facility Costs Event2	$4,550	RentFacilityCostsEvent2Amt
Food And Beverage Event2	$1,767	FoodAndBeverageEvent2Amt
Entertainment Event2	$3,600	EntertainmentEvent2Amt
Other Direct Expenses Event2	$21,996	OtherDirectExpensesEvent2Amt
Other Events Total	1	OtherEventsTotalCnt
Gross Receipts Other Events	$10,606	GrossReceiptsOtherEventsAmt
Charitable Contri Other Events	$10,606	CharitableContriOtherEventsAmt
Non Cash Prizes Other Events	$10,600	NonCashPrizesOtherEventsAmt
Oth Direct Expnss Other Events	$2,629	OthDirectExpnssOtherEventsAmt
Gross Receipts Total	$168,690	GrossReceiptsTotalAmt
Charitable Contributions Tot	$107,167	CharitableContributionsTotAmt
Gross Revenue Total Events	$61,523	GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events	$47,311	NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events	$4,550	RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events	$1,767	FoodAndBeverageTotalEventsAmt
Entertainment Total Events	$3,600	EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events	$29,504	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$86,732	DirectExpenseSummaryEventsAmt
Net Income Summary	-$25,209	NetIncomeSummaryAmt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
THOMAS NAKATSUCHI DDS
EMPLOYEE-DENTIST - FORMER	$196,505	$0	$0	$0	$0	$0	$6,900	$0	$5,615	$0	$209,020	$0	$0	$0
DIEU VO DDS
EMPLOYEE-DENTIST	$132,660	$0	$0	$0	$0	$0	$0	$0	$5,615	$0	$138,275	$0	$0	$0
SUZANNE RUSSELL
EXECUTIVE DIRECTOR	$82,108	$0	$0	$0	$0	$0	$2,700	$0	$5,615	$0	$90,423	$0	$0	$0
ALEXANDRA CHAMBERLAIN
DIRECTOR OF DEVELOPMENT	$63,359	$0	$0	$0	$0	$0	$0	$2,018	$0	$0	$63,359	$2,018	$0	$0
RACHEL WILLIAMS
EMPLOYEE-DENTIST - FORMER	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0			$0	$0
MARTIN DUNNE DDS
EMPLOYEE-DENTIST - FORMER	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0			$0	$0
KIM TRINH
EMPLOYEE-DENTIST - FORMER	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0			$0	$0
JU LAWRENCE
EMPLOYEE-DENTIST - FORMER	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0			$0	$0
ANDREA N LIVINGOOD DDS
EMPLOYEE-DENTIST - FORMER	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0			$0	$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11B	KEY OFFICERS OF THE ORGANIZATION REVIEW THE TAX RETURN BEFORE SIGNING AND FILING
FORM 990, PART VI, SECTION B, LINE 12C	THE CONFLICT OF INTEREST POLICY IS MONITORED ANNUALLY AND INTERESTED PARTIES WOULD REPORT ANY POTENTIAL CONFLICTS AS THEY SHOULD ARISE.
FORM 990, PART VI, SECTION B, LINE 15	COMPENSATION PROCESS FOR TOP OFFICIAL: THE EXECUTIVE COMMITTEE PERFORMS AN ANNUAL REVIEW AND SALARY REVIEW FOR THE ORGANIZATION'S EXECUTIVE DIRECTOR.
FORM 990, PART VI, SECTION C, LINE 18	DOCUMENTS ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE FOR PUBLIC INSPECTION VIA MONTHLY PUBLIC BOARD MEETINGS AND UPON REQUEST.